| NPI | 1528440054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1016319) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 294185) |
| 207P00000X Emergency Medicine (Licence: RI DO01283) | |
| 207P00000X Emergency Medicine (Licence: NY 294185) | |
| Enumeration Date | 2015-06-21 |
| Last Update Date | 2025-10-20 |